September 17, 2015

The Centers for Medicare & Medicaid Services is now considering Philips Healthcare recommendations on how to improve payment policies for Medicare services provided by physicians and hospital outpatient departments.Philips made the recommendations in response to CMS proposals on payment rates and policies for such services during calendar year 2016.

Philips urged CMS to take the following actions, among others:

Take manufacturer views into account in adjusting misvalued payment codes for imaging procedures;

Reconsider the expected utilization rate of radiation treatment equipment used in imaging centers;

Increase the payment for low-dose CT screening for lung cancer and proceed with implementation of the 2015 national coverage decision approving such screening;

Begin a pilot project that employs telehealth and coordinated, team-based care more broadly to address needs of patients with multiple chronic conditions; and

Refrain from finalizing the proposed restructuring of imaging APC categories in Medicare’s hospital outpatient payment system

CMS is expected to take final action on its physician and outpatient payment proposals by November. They go into effect January, 2016.

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